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NHS IT system on critical list

A government report admits the inevitable: the £12.7bn NHS IT programme is on the brink of collapse...

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Published: 27 Jan 2009

Last Updated: 31 Aug 2010

Six years into the National Programme for IT, the House of Commons Public Accounts Committee has issued a comprehensive pasting of the scheme, whose grand ambition is to provide a single integrated set of IT systems and tools for the entire NHS.

The committee has stated that even the programme’s already-delayed completion date of 2014-2015 is now at serious risk of not being met – largely because of the withdrawal of another key contractor, Fujitsu. With only two of the four original IT partners in place – BT and CSC – there may simply be insufficient resources to do the work in time.

It has also questioned the process by which £6.2bn of contracts were awarded, saying it is not convinced that good value for money was achieved by the Department of Health. Something of an understatement, given that the scheme is already five years behind schedule and has suffered from a plethora of high-profile glitches from the off, including a widespread lack of enthusiasm amongst NHS staff for a system that doesn’t meet their needs and numerous warnings from industry experts that control of the vast programme – the UK’s largest single IT project ever – is just too centralised and top-heavy to work.

Things have got so bad that committee chairman Edward Leigh has suggested a final review in six months' time. If the scheme still shows no signs of improvement by then, he says, it might be time to consider pulling the plug on the whole thing. Or at least, for the Department of Health to let local NHS trusts make their own IT purchasing decisions, which amounts to the same thing.

Of course if the system were to be canned, it would raise grave questions about how much of the work already done could be salvaged, and what the impact on the already massively overburdened public purse would be. There are also suggestions that, if NHS Trusts do walk away, National Programme contractors may still have to be paid. Which Whitehall wonder was asleep on the job when that clause was slipped through?

There are those who see the whole sorry episode as proof that some technology projects are just too big and complex to manage, but here at MT we are not among them. What is clear is that the Government IT’s purchasing and management capacity is lamentably far from being up to the job. Instead of a 1960s-style, top-down, bureaucratic and inflexible system run the way civil servants like to do things, the project should have been built on a modern, agile and bottom-up basis, with local management autonomy based around a common set of technical standards. By breaking the whole down into many more discrete functional units, designed to deliver regular incremental benefits rather than a few big bangs, medical staff could have been brought onside and the chances of overall success raised significantly.

How many more government IT schemes have to fail before this vital lesson is learned?